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Economic Study

Cost analysis of HLA-identical sibling and voluntary unrelated allogeneic bone marrow and peripheral blood stem cell transplantation in adults with acute myelocytic leukaemia or acute lymphoblastic leukaemia

Bone Marrow Transplantation volume 30, pages 243–251 (2002)Cite this article

Abstract

Allogeneic stem cell transplantation (SCT) is one of the most expensive medical procedures. However, only a few studies to date have addressed the costs of HLA-identical sibling transplantation and only one study has reported costs of unrelated transplantation. No recent cost analysis with a proper follow-up period and donor identification expenses is available on related or voluntary matched unrelated donor (MUD) SCT for adult AML or ALL. Therefore, we calculated direct medical (hospital) costs based on 97 adults who underwent HLA-identical sibling bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT), and patients who received a graft from a MUD between 1994 and 1999. The average costs per transplanted patient were € 98 334 (BMT), €151 754 (MUD), and €98 977 (PBSCT), including donor identification expenses, 2 years follow-up and costs of patients who were not transplanted after they had been planned to receive an allograft. The majority of these costs was generated during the hospitalisation for graft infusion. For MUD transplants, nearly one-third of these costs was spent on the search for a suitable donor. For patients who were alive after 2 years, cumulative expenses were calculated to be €103 509 (BMT), €173 587 (MUD), and €105 906 (PBSCT).

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Acknowledgements

We are very grateful to Mrs LJH Spronk-Metselaar from the Department of Haematology of the University Medical Centre Utrecht who provided useful insights in the logistic process of allogeneic transplantation.

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Authors and Affiliations

  1. Department of Health Care Policy and Management, Institute for Medical Technology Assessment, Erasmus University Rotterdam, The Netherlands

    M van Agthoven, MT Groot & CA Uyl-de Groot

  2. Department of Haematology, University Medical Centre Utrecht, The Netherlands

    LF Verdonck & A Hagenbeek

  3. Department of Haematology, Erasmus University Medical Centre Rotterdam, The Netherlands

    B Löwenberg & JJ Cornelissen

  4. Department of Haematology, University Medical Centre St Radboud, Nijmegen, The Netherlands

    A V M B Schattenberg

  5. Europdonor Foundation, Leiden University Medical Centre, Leiden, The Netherlands

    M Oudshoorn

  6. Department of Haematology, Leiden University Medical Centre, Leiden, The Netherlands

    R Willemze

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  1. M van Agthoven
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  2. MT Groot
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van Agthoven, M., Groot, M., Verdonck, L. et al. Cost analysis of HLA-identical sibling and voluntary unrelated allogeneic bone marrow and peripheral blood stem cell transplantation in adults with acute myelocytic leukaemia or acute lymphoblastic leukaemia. Bone Marrow Transplant 30, 243–251 (2002). https://doi.org/10.1038/sj.bmt.1703641

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